慢性肾功能衰竭合并急性左心衰竭患者心肌酶和肌钙蛋白的意义分析

目的 探讨慢性肾功能衰竭合并急性左心衰竭患者心肌酶和肌钙蛋白升高的临床意义.方法 选择慢性肾功能衰竭合并急性左心衰竭患者38例（试验组）,另选取同期未发生急性左心衰竭的慢性肾功能衰竭患者42例作为对照组,检测两组肌酸激酶同工酶（CK-MB）、天冬氨酸氨基转移酶（AST）、心肌肌钙蛋白Ⅰ（cTnI）、肌酐的变化,并记录患者院内预后.结果 试验组CK-MB、cTnI均较对照组明显升高（36.23±14.27） U/L比（14.71士8.27）U/L、（11.26±5.04）μg/L比（5.24±2.31）μg/L],差异有统计学意义（P＜0.05）;两组AST、肌酐水平均较正常值明显升高,但两组间比较差异无统计学意义（P＞0.05）;试验组院内病死率明显高于对照组47.37％（18/38）比16.67％（7/42）],差异有统计学意义（P＜0.01）;多因素分析结果显示,CK-MB、cTnI均是影响慢性肾功能衰竭合并急性左心衰竭患者预后的独立危险因素（r=5.03,3.27,P＜0.05）.结论 慢性肾功能衰竭合并急性左心衰竭患者心肌酶和肌钙蛋白的升高对预后有评估作用.

Analysis the significance of cardiac enzymes and troponin in chronic kidney failure combined with acute left heart failure patients

Objective To analyze the significance of cardiac enzymes and troponin in chronic kidney failure combined with acute left heart failure patients.Methods Thirty-eight chronic kidney failure combined with acute left heart failure patients were chosen as the experimental group,and 42 chronic kidney failure without acute left heart failure patients were chosen as the control group.The changes of creatine phosphokinase isoenzyme-MB （CK-MB）,aspartic transaminase （AST）,cardiac troponin Ⅰ （cTnI）,creatinine were tested and compared.The prognosis of two groups was recorded.Results The level of CK-MB,cTnI in experimental group were significantly higher than those in control group （36.23 ± 14.27） U/L vs.（14.71 ±8.27） U/L,（11.26 ± 5.04） μ g/L vs.（5.24 ± 2.31） μ g/L] （P 〈 0.05）.The level of AST,creatinine in two groups were higher than normal value,but there were no significant differences between two groups （P 〉0.05）.The fatality rate in experimental group was significantly higher than that in control group 47.37%（18/38）vs.16.67%（7/42）]（P〈 0.01）.Multiple stepwise regression analysis showed that CK-MB,cTnI were independent factors of prognosis （r =5.03,3.27,P 〈 0.05）.Conclusion The level of cardiac enzymes and troponin are important for the prognosis of chronic kidney failure combined with acute left heart failure patients.